Evaluation of influenza vaccination services and users’ perception about its utility: a study in a community pharmacy in Lisbon, Portugal

Poster presented at the 25th European Congress of Clinical Microbiology and Infectious Diseases (ECCMID). Copenhagen, Denmark, 25–28 April 201

Trends in income inequality: comparing the United States and Portugal

This article presents a comparative analysis of the United States and Portugal in terms of economic inequality from the early twentieth century to the present decade. We use different measures of inequality from several statistical sources. The article revolves around three complementary points. The first is a synchronic and diachronic analysis of economic inequalities in Portugal and the United States, the second is the issue of redistribution of income and the final analysis addresses the evolution of top incomes in both countries.info:eu-repo/semantics/acceptedVersio

National trends in the use of oral chemotherapy over 13 years

Funding Information: To the expert panel who validated the CDDs for the three indications and INFARMED I.P. for making data available. Publisher Copyright: Copyright © 2022 Moreira, Bernardo, Ramos, Aguiar and Alves da Costa.Background: Systemic cancer therapy has traditionally been administered using an intravenous (IV) route, implying patients’ frequent visits to hospitals to access to their therapy. If we consider the actual pipeline in oncology, oral chemotherapy will be the main component of cancer treatment in the next few years. This shift in the administration route requires different care models in order to guarantee treatment efficacy and safety. Objective: To analyze time trends in oral chemotherapy consumption in Portugal. Method: Oral chemotherapy consumption over a 13-year period (2008–2020) was analyzed, considering dispensed units by the administration route with respective costs, resorting to the drug regulatory agency (INFARMED I.P.) database. Oral consumption patterns were further explored using common daily doses (CDD) for three conditions, including chronic myeloid leukemia (CML), non-small-cell lung cancer (NSCLC), and breast cancer (BC), to adjust for the effect of varying doses. Data were analyzed descriptively resorting to Microsoft Office Excel 2010. Results: Overall chemotherapy consumption increased +Δ54.7%, with the highest contribution in units observed in oral forms (+Δ58.8%). The total expenditure increased +Δ96.5%, and despite the increase in oral forms (+Δ221.6%), intravenous forms continued to be the major cost driver, with an important contribution from immunotherapy. Much of the increase was led by the approval of 40 new IV and 48 new oral cancer medications with higher costs introduced in the market. Using CDD as an alternative metric to units had varying impacts by indication. The observed increases seemed to focus on specific cancer sites with varying effect; in CML, there was a 2.39-fold increase, compared to 4.41 for NSCLC and 1.86 for BC. However, for BC, two distinct sub-patterns were observed for hormone therapy (increasing 1.83) and for the novel tyrosine kinase inhibitors (increasing 40.8). Conclusion: The growing use of oral chemotherapy is obvious and calls for investments in supporting patients in managing medication adherence and adverse events. The shifts in the healthcare system are complex and need to be prioritized. Our data suggest that priority could be attributed to cancer sites driving innovation, namely, advanced breast cancer.publishersversionpublishe

Seca do frutos do açaizeiro no estado do Pará.

Objetivou-se relatar a seca dos frutos do açaizeiro, em três diferentes municípios do estado do Pará, safra 2014. Amostras de frutos secos dos municípios de Abaetetuba e Belém foram analisadas no Laboratório de Fitopatologia da Embrapa Amazônia Oriental e do município de Igarapé Mirim no Laboratório de Microbiologia de Alimentos do IFPA - Campus Castanhal, respectivamente. Os frutos foram incubados em caixas do tipo 'gerbox' à temperatura de 25±2 ºC e fotoperíodo de 12h, durante até 72h. Procederam-se isolamentos diretos em placas de Petri com meio de cultura ágar-água a 20%. Frutos com esporulação do patógeno foram utilizados para o isolamento direto, sem incubação prévia, e analisados em microscópios estereoscópio e de luz. Após três dias de incubação, discos de micélios foram repicados para o meio de cultura batata dextrose ágar (BDA). Observaram-se crescimento micelial branco e, após 10 dias de incubação, verificou-se a formação de colônias de coloração acinzentada nas placas de Petri. Foram confeccionadas lâminas para microscopia de luz. Verificaram-se a presença de hifas septadas e ramificadas e intensa produção de conídios unicelulares hialinos, em ambas as amostras. A doença seca dos frutos foi confirmada em amostras oriundas dos municípios de Abaetetuba, Belém e Igarapé Mirim, com associação do fungo Colletotrichum spp

Hyaluronan functionalized pH-responsive calcium carbonate nanoparticles for local treatment of breast cancer

[Excerpt] Introduction: Current radio- and chemotherapies are not efficient and many tumors remain resistant to conventional cancer treatments. Specific properties and signaling molecules from tumor microenvironment (TME) have been explored to increase treatment efficacy. An example is the acidic pH of the TME that has been explored to develop stimuli responsive release systems. Herein, we obtained biocompatible calcium carbonate (CaCO3) nanoparticles that are stable at neutral pH but dissolve at acidic conditions and evaluated their potential as a drug carrier for local cancer treatment. METHODS: CaCO3 nanoparticles were produced by co-precipitation of calcium chloride (CaCl2) and sodium carbonate (Na2CO3) in the presence of ethylene glycol [1]. Rhodamine was encapsulated as a model drug. The morphology and diameter of the nanoparticles were determined by scanning electron microscopy and dynamic laser scattering. The particles were coated by layer-by-layer (LbL) assembly of poly-L-lysine and hyaluronic acid (HA). The release was studied in phosphate buffered saline at pH 6.3 and 7.4. Cultures of two breast cancer cell lines (MDA-MB-231 and SK-BR-3) and a healthy epithelial cell line MCF10A (control) were observed under confocal laser scanning microscopy to assess particles internalization and their effect on cell viability (live/dead staining) and metabolic activity (Alamar Blue). [...]Portuguese Fundação para a Ciência e Tecnologia (FCT, grants CEECIND/02842/2017, SFRH/BPD/85790/2012; project PTDC/CTM-REF/0022/2020)

Layer-by-layer coated calcium carbonate nanoparticles for targeting breast cancer cells

Breast cancer is resistant to conventional treatments due to the specific tumour microenvironment, the associated acidic pH and the overexpression of receptors that enhance cells tumorigenicity. Herein, we optimized the synthesis of acidic resorbable calcium carbonate (CaCO3) nanoparticles and the encapsulation of a low molecular weight model molecule (Rhodamine). The addition of ethylene glycol during the synthetic process resulted in a particle size decrease: we obtained homogeneous CaCO3 particles with an average size of 564 nm. Their negative charge enabled the assembly of layer-by-layer (LbL) coatings with surface-exposed hyaluronic acid (HA), a ligand of tumour-associated receptor CD44. The coating decreased Rhodamine release by two-fold compared to uncoated nanoparticles. We demonstrated the effect of nanoparticles on two breast cancer cell lines with different aggressiveness â SK-BR-3 and the more aggressive MDA-MB-231 â and compared them with the normal breast cell line MCF10A. CaCO3 nanoparticles (coated and uncoated) significantly decreased the metabolic activity of the breast cancer cells. The interactions between LbL-coated nanoparticles and cells depended on HA expression on the cell surface: more particles were observed on the surface of MDA-MB-231 cells, which had the thickest endogenous HA coating. We concluded that CaCO3 nanoparticles are potential candidates to carry low molecular weight chemotherapeutics and deliver them to aggressive breast cancer sites with an HA-abundant pericellular matrix. This work was supported by the Fundação para a Ciência e Tecnologia (project OncoNeoTreat, grant number PTDC/CTM-REF/0022/2020, co-financed by FCT – OE component); and the European program FEDER/FEEI. R.R.C. acknowledges FCT for support through grants 2022.00764.CEECIND and CEECIND/02842/2017. D.S.C. thanks FCT for the grant SFRH/BPD/85790/2012. Parts of Fig. A.1 were drawn by using pictures from Servier Medical Art. Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License (https://creativecommons.org/licenses/by/3.0/)

Raising Awareness and Early Detection of Atrial Fibrillation, an Experience Resorting to Mobile Technology Centred on Informed Individuals

Background: Atrial fibrillation (AF) is a cardiac arrhythmia responsible for one third of ischemic strokes. Early detection of AF plays an important role in preventing embolic stroke. Objectives: This study aimed to test the feasibility of an awareness event including opportunistic screening for atrial fibrillation; and to test the reliability of the innovative portable electrocardiogram (ECG) device used. Methods: An awareness campaign was held during two weeks, where individuals consenting to participate in a pharmacist-led detection event, received a manual pulse check, were clinically evaluated and subject to a single-lead electrocardiogram using AliveCor Kardia® mobile. ECGs highlighted as possible AF were confirmed by the cardiologist and those signalled with abnormalities in cardiac rhythm were referred to their physician. Data were collected in a password protected application and analyzed using SPSS, v.24. The Kardia® mobile's sensitivity and specificity was tested against the standard 12-lead ECG. Results: The awareness event involved 223 individuals, among which 205 were screened. Mean age was 66 years (SD = 15) and hypertension was the most frequently reported (n = 107; 52.2%). Mean CHAD2DS2- VASc score was 3 (SD = 1.8). Cardiac irregularities were identified in 45 individuals, 14 confirmed to be new cases of AF (6.8%) by the cardiologist. The sensitivity and specificity were 90.9% and 97.4%. Conclusion: Data suggests this device to be potentially useful for opportunistic early detection of AF, provided interprofessional collaboration is guaranteed so that suspect cases are adequately managed and in a timely way. Fourteen new cases of AF were identified in the population studied, suggesting the pharmacist working in a multiprofessional context, may have had an important role in preventing potential ischemic-related strokes with this initiative. All healthcare professionals involved in the patient pathway should play a more active role in contributing to better health outcomes, particularly within primary care.info:eu-repo/semantics/publishedVersio